{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:27:49Z","timestamp":1791221269579,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children. Roughly a quarter of paediatric patients with NAFLD develop nonalcoholic steatohepatitis and fibrosis. Here, we evaluated the diagnostic accuracy of previously published noninvasive fibrosis scores to predict liver fibrosis in a large European cohort of paediatric patients with NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 457 patients with biopsy\u2010proven NAFLD from 10 specialized centers were included. We assessed diagnostic accuracy for the prediction of any (F\u2009\u2265\u20091), moderate (F\u2009\u2265\u20092) or advanced (F\u2009\u2265\u20093) fibrosis for the AST\/platelet ratio (APRI), Fibrosis 4 score (FIB\u20104), paediatric NAFLD fibrosis score (PNFS) and paediatric NAFLD fibrosis index (PNFI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients covered the full spectrum of fibrosis (F0:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009103; F1:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009230; F2:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200978; F3:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944; F4:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). None of the scores were able to accurately distinguish the presence of any fibrosis from no fibrosis. For the detection of moderate fibrosis, area under the receiver operating characteristic curve (AUROC) were: APRI: 0.697, FIB\u20104: 0.663, PNFI: 0.515, PNFS: 0.665, while for detection of advanced fibrosis AUROCs were: APRI: 0.759, FIB\u20104: 0.611, PNFI: 0.521, PNFS: 0.712. Fibrosis scores showed no diagnostic benefit over using ALT\u2009\u2264\u200950\/\u2009&gt;\u200950 IU\/L as a cut\u2010off.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Established fibrosis scores lack diagnostic accuracy to replace liver biopsy for staging of fibrosis, giving similar results as compared to using ALT alone. New diagnostic tools are needed for Noninvasive risk\u2010stratification in paediatric NAFLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.12068","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T22:45:18Z","timestamp":1703889918000},"page":"27-35","source":"Crossref","is-referenced-by-count":37,"title":["Noninvasive scores are poorly predictive of histological fibrosis in paediatric fatty liver disease"],"prefix":"10.1002","volume":"78","author":[{"given":"Laura","family":"Kalveram","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology, Nephrology and Metabolic Medicine Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t zu Berlin and Humboldt\u2010Universit\u00e4t zu Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Baumann","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases Hannover Hannover Medical School Hanover Germany"},{"name":"Institute of Immunology and Immunotherapy University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"De Bruyne","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Nutrition Ghent University Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Draijer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam  Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Janczyk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hepatology, Nutritional Disorders and Paediatrics, Children's Memorial Health Institute Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Kelly","sequence":"additional","affiliation":[{"name":"Liver unit, Birmingham Children's Hospital University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart G.","family":"Koot","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam  Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Lacaille","sequence":"additional","affiliation":[{"name":"Gastroenterology\u2010Hepatology\u2010Nutrition Unit H\u00f4pital Universitaire Necker\u2010Enfants maladies Paris 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Mosca","sequence":"additional","affiliation":[{"name":"Hepatology, Gastroenterology, Nutrition, and Liver Transplantation Unit Bambino Gesu' Children's Hospital, IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Rajwal","sequence":"additional","affiliation":[{"name":"Children's Liver Unit Leeds Teaching Hospitals NHS Trust, Leeds Children's Hospital Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Socha","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hepatology, Nutritional Disorders and Paediatrics, Children's Memorial Health Institute Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Vreugdenhil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Maastricht University Medical Centre Maastricht 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